Cefaly for Migraine: Diminishing Returns & No Long-Term Relief

My early success with the Cefaly, the external nerve stimulator I told you about last summer, didn’t hold up. I used it for at least an hour a day for six months, over which time my relief from it decreased from three hours a day to no relief at all. None of the published studies on the Cefaly talk about this happening, but none of them studied its use for more than a few months.

The Cefaly can be used to stop migraine attacks in progress (and to stop other types of headaches, according to the manual, though all the published research is on migraine) or as a daily preventive. Since I have (had!) migraines every day, I hoped for both. Not only did I experience diminishing returns of acute relief, I never noticed a preventive effect. Stopping it did not increase my migraine frequency, severity or duration.

I’ve heard from about a dozen of you who tried the Cefaly. No one reported relief even as significant as I had early on and half couldn’t use the device because the sensation in their foreheads was unbearably painful. The Daily Headache readers tend to have chronic and/or severe chronic disorders, so we’re unlikely to be a representative sample. Maybe it’s less effective for people with more severe headache disorders or our propensity toward more significant allodynia (sensitivity to touch) makes it more painful than normal. (If you’re worried it will be painful for you, see if someone you know has a TENS unit you can try. The Cefaly is different than a standard unit in its electrode shape and preset programs, but you’ll get an idea of what it feels like.)

Do I rescind my recommendation? Somewhat surprisingly, no. As long as it’s in your budget (it is returnable, but you’ll be out shipping to and from Canada and a 20% restocking fee), I say go for it. We all respond to different treatments and several headache specialists have told me that even a 10% response rate in early research is encouraging. If you want to explore nerve stimulation without invasive surgery, want a drug-free treatment or haven’t had much luck with standard treatments, the Cefaly is, at the very least, worth a try.

I still have mine and will try it again soon. I’m hopeful that a few months without it will be a sort of reset.

49 thoughts on “Cefaly for Migraine: Diminishing Returns & No Long-Term Relief”

  1. I have been using this device since about four days ago, both with the abortive and preventative treatment modes. It is OK with the preventative and I don’t have a migraine, but when I put on the device at the start of a migraine I feel like it gets worse. I can’t last out the 60 minutes. I start to feel very nauseous and the back of my neck is extremely tight. A tight neck is a migraine trigger, so this is the last thing I need.

    I’m so glad I found this blog. So often we are “Gaslite “when we say that there’s something amiss with a treatment that seems to work perfectly for everybody on the website. It makes you feel very defective, or at least that’s how I felt until I found this blog. Like there’s one more thing wrong with me because this isn’t working. I start doubting whether or not a “want” to get better. Thank you all for sharing your experience. I’ll continue to try the preventative as long as I don’t have a migraine. Has anyone else experienced the nausea and neck tension?

  2. I got my Cefaly last week. Each time I try it for 60 minutes, my forehead tingles for about 45 minutes and my migraine comes back about twice as bad as it was before I put the device on. Is this uncommon?
    I have Chronic migraines that never go away. I have great concern about continuing to use the device.

    1. Hi Chris, please ask your doctor for advice. I’d personally stop using it while waiting for an answer. Anything that makes a migraine attack twice as bad seems like something to avoid until you advice from a medical professional!

      Take care,

  3. Migraine triggers and modes of relief tend to vary greatly from one person to the next. I have not heard of any “single” treatment that works universally for the majority of Migraine sufferers. For some, Botox treatments result in greatly diminished occurance and severity of headaches; yet many others find that it has little to no impact upon their Migraine’s. I tried Botox and countless other prophylactic options to reduce my own Migrains; without any noticeable impact. (I’m 55, and have suffered from Migraines, since I was a young child.) Shortly after the Cefaly Device was approved for sale in the U.S., I purchased the original headband version. My only regret is that this wasn’t available, decades earlier. I am among those who have experienced a dramatic decrease in Migraine onset and severity. (A reduction of about 90%). Where I once had Migraine Headaches 4-5 days per week (At least one of which would be severe enough to prevent me from doing anything, other than lying down in a cold, dark room) I now experience 1-2 headaches a Month and the really severe ones are down to 2-3 per year.

    I have since upgraded to the newer, dual-mode version of the device (The FDA took 4-5 years longer to approve this, after it had already been approved in the E.U.) The newer version has modes for both reduction of headache occurance; as well as accute treatment of Migraine’s.

    As an added benefit, I find that use of the device is extremely relaxing. I have had sleep disorders for decades and find that use of the Cefaly at bedtime helps me to fall asleep, far sooner than if I don’t use it.

    Considering that Cefaly offers a money-back trial period; I don’t see why anyone with chronic Migraine’s wouldn’t give it a try. The only thing you have to loose is your pain. For me, it has been a life-saver.

  4. Oh – I just found my blog – it was last year! Blimey that has been a long year. So that’s just over a year I’ve had this device. Well I continued with the preventative setting for a few months, then gave it a rest then plucked up enough courage to try it when I get a migraine. Still stand by the centipede aspect, it’s definitely lowered and shortened the pain aspect and I’m still glad I took this punt. I too went to a neurosurgeon – who hadn’t heard of cefaly, told me it probably wouldn’t work, and prescribed me a drug with brain fog side effects instead. I picked up the prescription, read the info sheet, read as much as I could find on Google Scholar about the medication, and threw it all out. I like my ability to think too much.

  5. Hi. I wrote to this blog a few months after I purchased a Cefaly. That would be nearly 2 years ago. I’ve did the 20mins per day prevention thing for a couple of months but it seemed to scour my head out and leave me a bit zombie like. So I stopped using it for a couple of months and debated whether or not to touch it again. I did begin using it again when I get a migraine, and put it on the session as per instruction manual. I’ve been doing this more or less consistently for a year now – and at a couple of migraines a month that adds up. Anyways – I have found overall that the migraines decreased markedly in both pain and length after those first few months of “preventative” use. Probably a 7-9 on the pain scale down to a 3-4. I also find that being able to put the Cefaly on my head when I do have a migraine, does ease it and that the migraine lasts a shorter length of time on average. Sometime I just do one round of the migraine setting, and other times I run it 3-4 times in a row. I at least have found this product to be useful and am glad I stumbled across it. Migraines as we all know are incredibly individual and sadly it seems everyone has to discover what works for them. Would be easier if there was a one size fits all fix – I’d certainly be in the queue after 40 years(!) of these wretched things.

  6. WHen will they be able to cure migraines, I can’t use drugs they don’t work, I have a diet free of all allergy triggers for migraines, it frustrates me that the medical world has not come up with a cure for migraines , mostly women have them, is that the reason perhaps why it hasn’t been researched enough to help them. We have always been left in the wind woman, men do have them also, but it is primarily a womens extremely painful debilitating , 1-6 days of suffering to the next migraine and on it goes. It has finally reached the point that the migraines occur so often that I lost consciousness twice. The pain of a migraine is so severe, Im sure the pain is very similiar to brain tumors. There is absolutely no excuse for this not being a treatable disorder by now. Unfortunately I never had to chance to do research work for the brain because I have been so disabled by this syndrome that is chronic and takes up to much time in suffering, I am led to the bed to the darkness , blocking all smell, and sound and vomiting non stop.

  7. I have used my Cefaly daily for 20 minutes and noticed the start of tinnitus almost immediately. Has anyone else had this side effect?
    Good luck to everyone!

  8. I’m 61 years old and have had migraines since I was 11. They have worsened with age. I experience about 2 migraines per week but also have daily chronic headaches, stress headaches, etc. Just a “headache” person. No meds./treatment (biofeedback, accupuncture, botox, etc.) seem to work. They are also hereditary on both sides of my family. I’m in pain management now. I purchased the Vefaly over 2 years ago with great hope, but I have not had success. The only thing is the sensation is at least a distraction. My Cefaly does not have settings that I’m aware of. Is there a way I can try mine at a different setting? Would any other headache sufferer like to try/purchase mine? Thank you for listening.

  9. HI Christopher, just wondering what was the outcome of your wife’s side effects ? I used it and gave me headaches across the brow but i was told to persevere with it by my neuro an stupidly i did. It has worsened my migraine condition considerably and now 5 months later. This is a very dangerous device if administered wrongly like in my case but no one including doctors will admit this, i ‘m currently trying to find and research similar experieces to my own- even my neuro won’t admit it. THIS IS A DANGEROUS DEVICE.

  10. So here’s the situation- my wife’s neurologist prescribed the Cephaly… problem is that it actually gives my wife severe headaches in the front of her head and behind her eyes. I can’t find anything on the net about this, and she’s supposed to be using it everyday for the next two months… what should we do???

    1. Hi Christopher, I recommend contacting her neurologist for guidance. My doctor told me to stop using it immediately if it made my migraines worse, but I can’t extrapolate his advice to anyone else.

      Take care,

  11. Week one of my trialling Cefaly. It’s like having a centipede walk along your eyebrows..pins and needles. The sensation into the forehead is odd. I’ve been using prog 2 and halted the intensity fairly early on. I got a whopper of a migraine last night and have had it all today. Used Cefaly last night – prog 1 x 4 times. It’s still intense pain, bit it’s very diff to normal, more dispersed than knife, if that makes sense. I’ve had migraines since puberty and averaging about 3-6 a month, pain scale varying between 5-off the scale. Like everyone else I’ve run a gammut of pharma and non-pharma ways to manage this. So Cefaly is a pricey punt and hopefully it’ll pay off. The research literature looks to be majority favourable about results. User blogs like this are less convincing. If you are outside the States or Canada – and in the Pacific -Australia is your nearest vendor source. Will see how it goes.

  12. I have been using Cefaly for two months and have seen remarkable success. I decided to try Cefaly because although Botox was working great I could no longer afford it. From the 1st day I was able to use the device for the full 20min because of that I feel like I saw results sooner. After about a month I felt some improvement and 2 months in I feel the results are comparable to when I was taking Botox. Although I just realized tonight that the Pruritus I have been experiencing started about the same time I started Cefaly. Just wondering if anyone else has had chronic itching after using the device.

  13. Hi. I have chronic migraines – I have them almost daily. I’ve been using the Cefaly for about two months for 20 minutes per day with absolutely no impact or change in the amount of migraines or length of time they come for. It only halted an active migraine once (it came back later). The first week I used it, I could only use it on the lowest setting as it was horribly painful and even now I sometimes have to hit the button to stop the pain level increasing. The only benefit I have found from using Cefaly is that it makes me sleepy. Which helps with insomnia. Has anyone else also experienced no impact to their migraines with the Cefaly?

  14. Kerrie, I wrote to the above email and haven’t heard from anyone. I have a upcoming MRI scheduled by my neurologist. The pain in my head is still there and the stabbing pain in my left ear and my left eye is still as strong. Will keep you updated. Thank you

  15. I don’t have a h/a specialist as I rarely get them I don’t have migraines either. I went to the drug reps presentation because my grandson gets them. They just chose me to do demonstration. I just hope this isn’t going to be a long term effect. I will make a appointment to get checked out. Thank you.

    1. Maggie, I contacted someone I know at Cefaly. She said that ear pain has never been reported to the company. She recommended explaining what happened to their medical department to see if they can help. To contact them, email and write “attn: Cefaly medical department” in the subject line.

      Take care,

  16. We had a drug rep come to my place of work and She used me as a subject to demonstrate the product. It was left on me for 10 mins as people started asking questions about the product. I began to feel horrible pain in my head and told her. She said she shouldn’t have left it on me for so long as it was the fist time I had used it. This was 2 weeks ago. I have had head pain, tingling in my lips and stabbing nerve like pain in my left ear. The stabbing pain in my left ear causes my left eye to twitch. This is very very painful! I am very concerned that this is not going to go away. Have there been any reports of these types of side effects?

    1. Maggie, I haven’t heard reports of this type of side effect, but a doctor would know better. If you have a headache specialist, please contact them–they’re the most likely to have experience with the device. Best wishes for quick relief. Please let us know what you learn.

      Take care,

  17. I started using cefaly about 7 days ago. I let it go full force from day one because I wanted it to start relieving my migraines asap. It hurt like heck, but for 3 days straight I did not have a single migraine. I was so happy because I never went 3 days without a migraine. Here comes the disappointment. The 4th day I woke up with a terrible migraine. And from then on have been back to my regular migraines with no relief. In fact, each time I used the cefaly, it would give me a terrible headache. I had to stop and will have to return it. I’m so disappointed. I had so much hope with this device. I want a life again so badly, but severe migraines makes it so that I cannot have a normal life. I guess I have to accept the fact that I won’t have a normal life unless by some miracle a real cure is found. Terribly disappointed, sad, and hurting.

  18. Does anyone know if Cefaly addresses occipital migraines? That is, migraines at the back of the head? I have chronic migraines but 80% are in the back of my head.

  19. Hello I am new to Cefaly. I am 46 years old and have suffered with migraines since childhood. I typically have daily migraines and have tried all possible meds, considering I have a severe sulfa drug allergy this limits some meds. I have also tried Blood pressure meds, diuretics, Botox, medical massage with physical therapy and TENS therapy. My Neurologist who specializes in headaches suggested Cefaly, so I decided to give it a try. Tonight was my third time using Cefaly. The feeling is a lot like TENS therapy just seems more powerful. I have not found it to be painful, but I have an intense itchy feeling on my forehead right where the electrode is placed. The itching feeling is pretty severe and takes everything for me to get through the 20 minute session. My forehead is not red when it is removed. Has anyone else experienced this? I seem to feel great right after the session, but has not lasted. I will continue to use Cefaly daily and hope and pray for some headache free days.

  20. I’ve been using Cefaly for two months. I’ve had 7-10 migraines a month for the past 8 years. My first month with Cefaly I saw no change. This month I got 17 migraines. Has anyone else seen an increase in headaches on Cefaly? I’m wondering if the frequency change is just part of the long term process of using it, and the headaches will start to diminish in the coming months? Not sure if I should power through for a few more months or quit using now.

    1. Anne, I don’t know of any hard data on this, but my headache specialist said he tells patients to quit using it if their migraine attack frequency increases. He has said he hadn’t seen anyone whose migraines get worse on it then get better while still using it.
      Best of luck finding relief.

      Take care,

  21. I’m really sorry it hasn’t worked out for you. Migraines are horrible. I guess I am “lucky” in that I don’t get them every day – i had been averaging 3-4 a month. The Cefaly for me has cut that down to about 1 a month, and this has been for about a year now. Also, I have the Canada version – I use setting 2 for prevention. I also use it if I feel a migraine coming on. But when I use it to abort, the Canada version lets you repeat the program multiple times at full intensity, without going through the whole buildup period. If it feels like it will be a bad one, I have repeated the program 3 and 4 times in a row. I am pretty numb at the end of it but I have found that when I do that, the migraine either doesn’t come on, or it lasts only a day, instead of the 3-4 days they had lasted. Thanks for the blog – I hope you can find something that works for you soon.

  22. I have used the cefaly now for over four months and not seen much relief. I have migraines 10-15 days a month and they usually come several days at a time. There have been a few times when the cefaly seemed to take away one that was just starting, but there have been just as many times (it seems) that the cefaly seems to have made the migraine worse. My neurologist can’t believe that the cefaly is not working for me and I think he has given up on me. I see a lot of posts from others that the cefaly is working for and that is wonderful news. Don’t know whether to continue to use it in the hopes that one day it will work, or just discontinue it altogether?

  23. Hi, I recently purchased Cefaly just over 2 weeks ago it arrived, I used it and although it was incredibly painful, after less than a week my pain was slightly decreased overall, however this week it has gone back up despite using Cefaly as much as I was the previous week. Can this happen? You get relief for a short period and then it stops helping?
    I’m at a loss at what to do, whether I should continue, whether the relief will come back, or has my body got use to the device and it is no longer going to help. I have New Daily Persistent Headache which is severe most of the time.
    There seems to be no information online other than this post about it eventually stopping helping, I’ve posted on the CMA group on Facebook but no one who has commented so far has experienced it helping and then it stopping helping.

    1. Sian, I’d talk to your doctor. I don’t think there’s any harm in continuing to use it even if you’re not seeing results immediately. It could be that it won’t work for you anymore, or it could be that you just need more time with it. Please let us know how it works out for you. My fingers are crossed.

      Take care,

  24. Cefaly has worked very well for me. If you’ve got a way to try it out, I’d say go for it. I’ve had it several months and it has an abortive effect and hopefully a preventive. Based on Canadian manual verbage, I’m exceeding FDA guidelines and using 2-3 times a day for 20 minutes. My neurologist is skeptical but sez at least it won’t hurt… Also, I have another TENS unit I use for a shoulder issue (works well) it’s adjustable and I found on its website a guide to pad placement and settings for various pain including Trigeminal Neuralgia… that’s the nerve migraine pain runs along isn’t it?

  25. I love my cefaly! I had every other day and sometimes daily migraines. Tried every ‘preventative’ known. Tried botox, acupuncture, that proceedure that cooks certain nerves to brain, herbs, and the list goes on and on. From the first day, the cefaly has been a miracle for me. 3 migraines in almost 6 weeks! I have all my toes and fingers crossed after reading here. It planted seed that maybe any day it will stop working. I’ll kill myself.

    1. Pat,

      I’m so glad it has been helpful for you. Remember that this is only my experience and I didn’t have great success with it to begin with. If it does stop working as effectively, your doctor may be able to help you figure out a different way to use it (for a shorter duration or at a different time of day, for example).


  26. I am looking into treatment options for my wife, as she has stopped topomax. When I went to the cephaly site, they state that they are not taking orders from the USA. Does anyone know where we can get one to try out?
    Thank you.

  27. Hi Kerrie – Thanks for posting this! I wish you would have experienced the relief that I have with Cefaly. It’s like night and day. My migraines are so much better! When I get one now I’m beside myself wondering how I dealt with it almost every day before. I hope you do indeed try again and that your migraines drastically improve!

    1. I’m glad to hear it is helping you so much! I’d love to know more about your experience so I can share a success story with others. I’m sending you an email with a bunch of questions.


  28. Kerrie:

    Thanks for all the info you have shared. I have checked in archives and seen your previous info on cefaly. Based on what you know now-and of course love if fellow migraine sufferers chip in. Where do you think the best online places to purchase this item are? And of course possible
    return policy if device does not work. I noticed Costco sells item online-but many persons don’t have Costco card. Amazon does not sell the item at all. Do you still recommend sites listed in prior postings? I notice that the website charges more than what can purchase item at other sites. Of course if going to direct website of Cefaly itself can purchase item-but notice the seem to charge a premium. Kerrie-I have read previous articles you have posted on Cefaly-just wanted to see if you or readers have new information on possible superior websites to purchase Cefaly. Thanks again for what you do.

    1. Hi Timothy,

      Just saw this — sorry for the delayed reply. The short answer is that is the only place to buy it in the U.S. and they have a 60-day return period if you aren’t satisfied with it.

      The longer answer: Costco in the U.S. doesn’t carry it. Costco Canada sells them, but does not ship to the U.S. The Canadian distributor used to ship to the U.S., but a company representative has told me that is longer the case.


  29. I have a cefaly, and have used it on and off for 1 year now. I find it’s really helpful with my tension headaches (doesn’t get rid of them, but provides some relief), and as long my migraine is not too full blown it can provide a nice distraction from the pain. It’s weird how my forehead keep buzzing afterwards though for a good 20 minutes after I turn it off!

  30. Hi Kerrie.

    I’ve tried the Cefaly for about 5 months, and I had the same experience as you. My expectations were not very high, but living with chronic migraine, I’m always hoping for a new treatment that will work for me! Well, not this time either…
    It would be great to have effect from a treatment that didn’t give bad side-effects, and in that sence, testing out the Cefaly is worth a try!

    1. Interesting. I’m sorry you didn’t get long-term relief from it either. A company representative emailed me after reading this post and said I was the first person she’d heard of who had diminishing returns. Even though the effects didn’t last, I’m also glad I tried it.

  31. I’m probably repeating myself, but – any therapy/treatment that doesn’t respect the fact that you and your migraine are a unity will not hold. You and your migraine are not two separate things. Your migraine is part of what you are, part of your overall, total picture. If a treatment leaves ‘you’ out of the picture, the ‘soil’ on which the migraine grows will let it grow back, and the roots of it grow deep.

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